Addressing the LDI 50th Anniversary Symposium, Louisiana Health Secretary Rebekah Gee urged federal policymakers to "focus on the issues that we really need to address, which are poor outcomes overall, increasing costs, lack of patient engagement, and lack of real state flexibility."

Offering the insights of someone who oversees health care in "the 49th sickest state," Louisiana Health Secretary Rebekah Gee told an audience at the University of Pennsylvania that the Washington policymaking process isn't adequately addressing the pragmatic needs of populations like hers.

Speaking to hundreds of academic health services and policy experts gathered at the Leonard Davis Institute of Health Economics 50th Anniversary Symposium in Philadelphia, Gee's remarks were perhaps the most candid of any of the event's four dozen speakers.

But they were also in keeping with her willingness earlier this year to engage in sharp public debate with Louisiana Senator Bill Cassidy, one of the authors of the now-failed Senate Graham-Cassidy-Heller-Johnson plan to repeal the Affordable Care Act.

"What's being talked about are major cuts without significant structural reform," she told the Penn audience. "Let's focus on the issues that we really need to address, which are poor outcomes overall, increasing costs, lack of patient engagement, and lack of real state flexibility. That means flexibilities like the ability to negotiate drug prices, the ability to work with Medicare to not pay for low value services, and thinking about shifting our funding into the social determinants of health. Those are the types of discussions we need to have."

Gee, MD, MPH, MSHP, has lived in Louisiana since 2009 and held a number of health department positions, including Director of the Medicaid program, prior to becoming its chief executive. She is also an Assistant Professor of Health Policy and Management and Obstetrics and Gynecology at Louisiana State University. She earned her MD from Cornell University Medical College, her MPH from Columbia, and her MSHP as a Robert Wood Johnson Foundation clinical scholar at Penn. Earlier this year, she was elected to the National Academy of Medicine where she was previously the inaugural recipient of a two-year Norman F. Gant/American Board of Obstetrics and Gynecology (ABOG) Fellowship.